Lima Tatiana Rafaela Lemos, Kasuki Leandro, Gadelha Monica Roberto, Lopes Agnaldo José
Rehabilitation Sciences Post-graduate Program, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil.
Neuroendocrinology Research Center/Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Neuroendocrine Unit, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria de Estado de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil.
J Bodyw Mov Ther. 2019 Jul;23(3):634-642. doi: 10.1016/j.jbmt.2019.01.006. Epub 2019 Jan 28.
Acromegaly causes numerous functional limitations that negatively impact patients' performance of activities of daily living (ADLs) and contribute to the deterioration of health-related quality of life (HRQoL). Thus, the purpose of the present case study was to evaluate the effect of therapist-oriented home rehabilitation (TOHR) for a patient with acromegaly.
We report the case of a 53-year-old man who was diagnosed with primary acromegaly 17 years ago. He complained of difficulties performing tasks that involved his hands, pain in the lower limbs, and fatigue when he climbed a few flights of stairs. Although he performed ADLs independently, he reported some difficulties or discomfort when performing them.
The patient underwent a booklet-guided physical exercise program that lasted two months (three times per week, 60 minutes per session). The activities included overall stretching, muscle strengthening, and endurance exercises, along with aerobic conditioning through functional circuit training. After two months of exercise, he reported improved HRQoL as assessed with the Acromegaly Quality of Life Questionnaire, with increases in quadriceps muscle strength and 6-min walking distance. However, none of these benefits remained when the patient was assessed after a 1-month washout period.
This study showed that patients with acromegaly may benefit markedly from TOHR, which could provide a novel therapeutic approach as an adjunct to hormone control therapy.
肢端肥大症会导致多种功能受限，对患者的日常生活活动（ADL）表现产生负面影响，并导致健康相关生活质量（HRQoL）下降。因此，本病例研究的目的是评估以治疗师为主导的家庭康复（TOHR）对一名肢端肥大症患者的效果。
我们报告一例53岁男性患者，17年前被诊断为原发性肢端肥大症。他诉说在进行涉及手部的任务时存在困难，下肢疼痛，爬几层楼梯就会感到疲劳。虽然他能独立完成ADL，但在进行这些活动时仍报告有一些困难或不适。
患者接受了为期两个月的手册指导体育锻炼计划（每周三次，每次60分钟）。活动包括全身伸展、肌肉强化和耐力训练，以及通过功能性循环训练进行有氧调节。经过两个月的锻炼，根据肢端肥大症生活质量问卷评估，他报告HRQoL有所改善，股四头肌力量和6分钟步行距离增加。然而，在1个月的洗脱期后对患者进行评估时，这些益处均未保留。
本研究表明，肢端肥大症患者可能从TOHR中显著获益，这可为激素控制治疗提供一种新的辅助治疗方法。
